Provider Demographics
NPI:1033486956
Name:BEREAN, TERRANCE J (OTR)
Entity Type:Individual
Prefix:MR
First Name:TERRANCE
Middle Name:J
Last Name:BEREAN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-2714
Mailing Address - Country:US
Mailing Address - Phone:914-277-5533
Mailing Address - Fax:
Practice Address - Street 1:520 ROUTE 22
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-2714
Practice Address - Country:US
Practice Address - Phone:914-277-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1386225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist